The proposed investigation is a pilot effectiveness trial of a collaborative mental health intervention for physically injured trauma survivors who suffer from Posttraumatic Stress Disorder (PTSD). The aim of the investigation is to pilot a 6-month collaborative intervention (i.e., continuous MSW posttraumatic case management, combined with ongoing access to consultative MD psychopharmacological, and PhD substance abuse counseling expertise), for physically injured trauma survivors. The investigation will randomize and follow 160 hospitalized trauma survivors for 12 months from their surgical ward admission through outpatient care and community rehabilitation. All participants will be screened for PTSD during the surgical inpatient admission and receive 1, 3, 6, and 12 month telephone follow-up interviews. For intervention subjects the investigators will make descriptive observations regarding the feasibility of delivering the collaborative mental health intervention. Observational data will be collected that documents the processes of collaborative care delivery so that a treatment manual can be developed. The investigation also aims to develop methods for assessing the cost-effectiveness of the intervention. Recipients of the intervention are hypothesized to demonstrate clinically significant decreases in PTSD symptoms and increased appropriate use of posttraumatic health services. The principal investigator is a junior mental health services researcher who is beginning the 3rd year of a 5-year (8/98-7/03) National Institute of Mental Health, Mentored Clinician Scientist Award (K08). Funds from the Agency for Healthcare Research and Quality R-03 award will primarily support the case management intervention. The ultimate goal of the investigation is to provide preliminary data that will further the development of a larger scale R-O1 funded randomized effectiveness trial.